- Location: Durham, NC
- Posted: Jan 3, 2020
Duke Primary Care is the largest primary care network in the greater Triangle area with family medicine and internal medicine providers, and pediatricians in 34 locations throughout the Triangle.
This exempt management position is responsible for overseeing all functions of the referral department, including but not limited to the hiring, training and development of staff. This position will manage, coordinate and participate in the administrative activities which support referral services for Duke Primary Care. The Referral Manager is a customer-service and leadership-focused position working staff who work with patients and their families, insurance representatives, doctors and other medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare to all patients. The manager is responsible for assuring the coordination of quality, cost-effective care.
This position is accountable for the program which processes outgoing referrals for Duke Primary Care practices, scheduling patient appointments and procedures with other offices, and coordinating with the patient to make sure they make their appointments. The Referral Manager is also responsible for supervising the referral staff and maintaining high standards of accuracy in a matrixed management environment. This position will have matrixed oversite for approximately 50 employees.
Duties and Responsibilities of this Level
Responsible for reporting information and triaging throughout the day for all Partners entities.
Develops guidelines for prioritizing work activities, evaluating effectiveness, and modifying activities as necessary
Conduct monthly staff and leadership meetings
Generate weekly/monthly/quarterly analysis reports
Ensure optimal customer service and follows through on all patient referral needs to ensure quality patient care and services
Monitors and prioritizes work by utilizing and coordinating staff resources to the fullest capacity; adjusts work
Trouble-shoots and researches patient referral issues and determines the cause and provides resolution
Work with HCAs to coordinate staff resources when intra-department cross-coverage is needed
Champions and assists department management with the implementation of department and Entity goals, objectives, policies, and priorities; establishing appropriate service, staffing levels, and allocation of resources accordingly
Is a member of the selection committee for hiring referral coordinators
Responsible f or orienting, training and coaching new and existing referral coordinators
Trains staff on specialty specific referral processing,exception reports, and insurance validation/pre-authorization
Administers mandatory in-services/ education and coordinates Referral Coordinator Skills-day
Mentors all existing team members and assists in identifying re-training subject matter
Provides feedback to HCAs regarding team member performance, systems and process issues
Manages 10-15 centralized team members performing referral support processing
Process Improvement / Change Management
Translate applicable business strategy, needs/gaps, and metrics into actionable opportunities designed to improve customer experience or realize cost savings
Proactively identifies opportunities to improve the patient referral process as a means to improve the efficiency
Develops short and long term work plans for goals of the department
Develops and evaluates appropriate protocols, work-flows, and guidelines for effective ness
Identifies trends and referral patterns - works with management for resolution
Analyze report data and provide weekly feedback/report to, the manager
Work requires communications, analytical and organizational skills generally acquired through completion of a bachelor's degree program. BSN Preferred.
Work requires the ability to plan and administer programs and direct program activities within a specific functional area, generally acquired through four years of related experience. OR ANY OTHER EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE
Demonstrate knowledge of insurance referral process
Knowledge of medical practice management, terminology, budgeting, and referral
Demonstrated skill in planning, organizing, delegating, and supervising.
The ability to handle multiple tasks and prioritize work effectively is a must.
Demonstrated ability to work and make decisions in a fast-paced, high volume work environment.
Excellent analytical ability to identify, investigate, analyze and resolve production issues.
Ability to meet production deadlines and goals in high volume, fast-paced environment
Knowledge of HIPAA Privacy Policies.
Excellent oral and written communication skills to effectively communicate with department staff and partner with other entities.
Ability to exercise diplomacy to resolve related issues
Ability to evaluate the effectiveness of existing methods and procedures.
Demonstrated problem-solving skills
Proficient with office software packages such as EPIC, MS Word and MS Excel.
Degrees, Licensures, Certifications
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.